Market Director Revenue Integrity Nevada

Market Director Revenue Integrity

St. Joseph's Hospital & Medical Center, Phoenix, AZ

Responsible but not limited to all revenue integrity related activities such as report preparation, department audits, reconciliation procedures, QA monitoring, denials management, revenue-based statistics, CDM (Charge Description Master) maintenance, training clinical staff on charge-capture processes and subsequent charge review post procedure. Supervises Market Manager(s) and has oversight of Revenue Integrity department operations for the assigned market(s).

The role oversees all market revenue integrity (RI) initiatives which include monitoring and approving all changes made to the hospital's charge description master (CDM) and fee schedules, and developing CDM strategies that will optimize revenue generation while ensuring compliance with Federal, State and payer regulations and guidelines. Responsible for managing value capture programs and tasked with root cause analysis and will coordinate with various departments to achieve solutions to revenue capture opportunities. Fosters partnering relationships with the Revenue Cycle team, System Office, Patient Financial Services, Compliance, Health Information Management department and educates hospital departments with respect to the use and maintenance of the (CDM).

This position directs all revenue integrity functions at the market level and is charged with implementing region and system level initiatives while being a Subject Matter Expert for their market. Works closely with Market CFO and is a standing member of the Market Operating Steering Committee (MOSC) for revenue cycle. Incumbent maximizes charge efficiency through: (1) Monitoring revenue cycle processes and staff functions; (2) Supporting CommonSpirit Health’s revenue capture and integrity through evaluating the accuracy of charge capture functions, and staying apprised of payer and/or regulatory updates; (3) Assisting in the design and implementation of Charge Capture workflow improvements.

• Assists with month end accounts receivable analysis, reporting and various monitors, including emphasis on facility pre-billing AR inventory management.
• Maintains a compliant charge master, standardized to the corporate standard, including timely additions, changes and deletions and applicable, while providing assistance to assure uniform application of the charge master in all revenue generating departments.
• Coordinates and recommends price increase changes annually and as needed to enhance the financial viability of the medical center as the primary source of income derives from appropriate patient revenues.
• Coordinates charge master reviews in total or by department as needed and provides education and assistance to all directors regarding the function and application of the charge master and the revenue cycle in general.

Bachelor’s degree in healthcare administration, finance, business administration or related field. Ten (10) years’ experience in healthcare related revenue cycle functions, including coding and billing guidelines may be substituted for a Bachelor’s degree.

Professional Certification or Credential from a National Organization, i.e. AHIMA, AAPC, HFMA or NAHRI highly preferred

Hello humankindness Located conveniently in the heart of Phoenix, Arizona,St. Joseph's Hospital and Medical Center is a 571-bed, not-for-profit hospital that provides a wide range of health, social and support services. Founded in 1895 by the Sisters of Mercy, St. Joseph's was the first hospital in the Phoenix area. More than 125 years later, St. Joseph's remains dedicated to its mission of caring for the poor and underserved. We are extremely proud to be a nationally recognized center for quality quaternary care, medical education and research. St. Joseph's includes the internationally renowned Barrow Neurological Institute, Norton Thoracic Institute, Cancer Center at St. Joseph's, Ivy Brain Tumor Center, and St. Joseph's Level I Trauma Center (which is verified by the American College of Surgeons). The hospital is also a respected center for high-risk obstetrics, neuro-rehabilitation, orthopedics, and other medical services. St. Joseph’s is considered a sought-after destination hospital for treating the most complex cases from throughout the world. Every day, approximately 20 percent of the hospital’s patients have traveled from outside of Arizona and the United States to seek treatment at St. Joseph’s. U.S News & World Report routinely ranks St. Joseph's among the top hospitals in the United States for neurology and neurosurgery. In addition, St. Joseph's boasts the Creighton University School of Medicine at St. Joseph's, and a strategic alliance with Phoenix Children's Hospital. St. Joseph's is consistently named an outstanding place to work and one of Arizona's healthiest employers. Come grow your career with one of Arizona's Most Admired Companies. Look for us on Facebook and follow us on Twitter. For the health of our community ... we are proud to be a tobacco-free campus.